Monday, June 9, 2014

PurAmino - Why aren't you easier to use?

Puramino.  Oh, Puramino.

There's a special place in my heart for this product.  I'd like very much for it to work out.  When we tried it a year ago, we only had two cans, and so could only trial for three days.  But unlike the other formulas we've tried, so far, nothing terrifying has happened while on PurAmino.  And this time, we were able to get much more in the way of samples, thanks to the tireless efforts of our R.D.  I'm excited, of course, but nervous - I really don't have the time for a hospital visit right now.

Actually, what I am mostly is annoyed.  PurAmino is a 20 calorie infant formula, with deceptively simple mixing instructions:

To Make Water Powder Weight
1 fl oz 1 fl oz 1 unpacked level scoop 4.5 g
2 fl oz 2 fl oz 2 unpacked level scoops 9 g
4 fl oz 4 fl oz 4 unpacked level scoops 18 g
8 fl oz 8 fl oz 8 unpacked level scoops 36 g

I'm guessing you see the pattern.  An ounce plus a scoop equals an ounce of finished product.  Easy peasy, right?  Right.  But let's say your kiddo needs a few more calories than your average bear.  You could just increase the volume that you feed - though in Aidan's case, we'd need to feed him 28.5 hours per day (you heard me) to get enough calories in with a 20 calorie formula.  Not humanly possible, next option please!

You'd probably check the can for 30 calorie mixing instructions.  After all, Neocate and Elecare has them.  No such luck.  You might also head to the product page on manufacturer's website, hoping for more detailed 30 calorie mixing instructions.  After all, 30 calorie dilution is standard for toddlers.

It took me a couple of hours of googling obscure combinations of phrases (and stumbling back across my own blog entry detailing my identical dilution quandary one year ago!) before I found this - a slightly helpful, more than slightly infuriating, piece of documentation.  WHO WROTE THIS THING?!

Here's my (hopefully not too terribly flawed) math:

We need 30 calories per ounce.  So we're only interested in the very bottom row.  We already know that 1 unpacked level scoop is 4.5g, and I use a gram scale, so that's how I prefer my measurements.

4.5g powder + .7oz water = .8oz formula
divided that all by .8 to determine that
5.625g of powder + .875oz water = 1 ounce of formula
at 30 calories per ounce, and knowing he needs 1350 calories, I multiply by 45 to get (roughly)
253g powder + 39.4oz water = 45oz formula

Redoing it in mL, since the manufacturer recommends this measurement for accuracy:

4.5g of powder + 19mL water = 23mL formula
divided by 23 to determine that
.196g powder + .826mL water = 1mL formula
at 1.01 calories per mL, and knowing that he needs 1350 calories, I multiply by 1337 to get (roughly)
262g powder + 1104mL water = 1337mL formula
262g powder + 37.3 oz water = 45oz formula

Um, say what?   Those are not the same.  After no small amount of crying and yelling at the can for not giving up more helpful information, I let the R.D. do her job.  I do not know exactly how she did this math.  I think she allowed for displacement.  And also, magic.  What I do know, is that I'm blogging this for future me to find.  In fact, I'll cross out my crappy flawed math.  Hey, future me.  Use this one!

266g powder + 38.5 oz water = 45oz formula

Once we decided to go ahead with PurAmino, we had an uphill battle with insurance.  It's an infant formula this, and we don't carry it that.  UGH!  I won't get into the dirty details because if I re-live it, I might actually have to hurt someone, but our wonderful, wonderful R.D. at CHOP worked her - ahhem - bottom off to get us enough samples to keep Aidan fed until our appeals were approved and our delivery finally arrived.  We repaid the Mead Johnson rep with these absolutely adorable pictures of one of their tiny consumers.

PurAmino - bottom line - I'll forgive your user-unfriendliness if you keep my baby out of the hospital.  Deal???


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  2. Caroline, I wish Aidan success on PurAmino! I am one step behind you on the formula caloric increase and your posts have been very timely! We have a dr appt Wed.
    All the best!